Depression Spectrum Research Articles

Qualification and predictors of the development of affective disorders in multiple sclerosi

Affective disorders occupy one of the leading places in the structure of comorbidity in multiple sclerosis, but the questions concerning etiopathogenesis, qualification, diagnosis, and prediction of these disorders remain controversial. The most important consequences of affective disorders in MS include a decrease in the patient's quality of life, adherence to treatment, and their daily activities, and an increased risk of suicide and death from cardiovascular diseases. In this regard, the need for early detection and prediction of the development of depression in patients with MS is obvious. The following factors are considered among the predictors of the development of emotional distress and affective disorders: social, psychological, demographic, neurocognitive, and treatment-related factors, neuroimaging data, lifestyle features, comorbidities, characteristics of multiple sclerosis and its social implications. Specifically, younger age at the time of diagnosis, the presence of dyssomnia, fatigue, consumption of dairy products, atrophy of cortical areas in the frontal lobes, and decreased white matter volume of the uncinate fasciculus predict the development of depression. This article reviews the features of depressive and bipolar spectrum disorders in patients with MS.

Modulation of neural circuits by melatonin in neurodegenerative and neuropsychiatric disorders.

Neurodegenerative and neuropsychiatric disorders are two broad categories of neurological disorders characterized by progressive impairments in movement and cognitive functions within the central and peripheral nervous systems, and have emerged as a significant cause of mortality. Oxidative stress, neuroinflammation, and neurotransmitter imbalances are recognized as prominent pathogenic factors contributing to cognitive deficits and neurobehavioral anomalies. Consequently, preventing neurodegenerative and neuropsychiatric diseases has surfaced as a pivotal challenge in contemporary public health. This review explores the investigation of neurodegenerative and neuropsychiatric disorders using both synthetic and natural bioactive compounds. A central focus lies on melatonin, a neuroregulatory hormone secreted by the pineal gland in response to light-dark cycles. Melatonin, an amphiphilic molecule, assumes multifaceted roles, including scavenging free radicals, modulating energy metabolism, and synchronizing circadian rhythms. Noteworthy for its robust antioxidant and antiapoptotic properties, melatonin exhibits diverse neuroprotective effects. The inherent attributes of melatonin position it as a potential key player in the pathophysiology of neurological disorders. Preclinical and clinical studies have demonstrated melatonin's efficacy in alleviating neuropathological symptoms across neurodegenerative and neuropsychiatric conditions (depression, schizophrenia, bipolar disorder, and autism spectrum disorder). The documented neuroprotective prowess of melatonin introduces novel therapeutic avenues for addressing neurodegenerative and psychiatric disorders. This comprehensive review encompasses many of melatonin's applications in treating diverse brain disorders. Despite the strides made, realizing melatonin's full neuroprotective potential necessitates further rigorous clinical investigations. By unravelling the extended neuroprotective benefits of melatonin, future studies promise to deepen our understanding and augment the therapeutic implications against neurological deficits.

Gut microbiota and geriatric health

Background: Each individual has a distinct gut microbiota composition that serves a variety of important roles in the metabolism of the host's nutrients, immunomodulation, and maintains immunity and inflammatory response and influences the gut–brain axis (GBA). In addition to modulating the immune system, the hypothalamic–pituitary–adrenal (HPA) axis, and tryptophan metabolism, microorganisms can synthesize several neurotransmitters and generate metabolites, such as short-chain fatty acids (SCFAs), that have neuroactive features. The gut microbiome is highly susceptible to lifestyle modifications, diet and xenobiotics, which leads to dysbiosis. Dysbiosis in the geriatric population can cause numerous disease conditions like Alzheimer's and Parkinson's disease, cardiovascular disease, gastrointestinal disease, and cancer. Dysbiosis of the gut microbiota has been associated with behavioural and neurological disorders such as depression, Alzheimer's, Parkinson's, and autism spectrum disorder. Furthermore, SCFA administration and microbiota alteration have been suggested as therapy objectives for these illnesses. DNA-based culture-independent methods, including next-generation sequencing, which provide quantitative information on the human gut microbiota are used to define the entire gut health and its relation to various disorders. The current review aims to summarize the available literature on the role of gut microbiota in ageing and dysbiosis in disease conditions.

Emotional Context Effects on the Rating of Ambiguous Facial Expressions in Depression and Schizophrenia Spectrum Disorders

Objective To investigate the influence of visual contextual information on emotion recognition of ambiguous facial expressions in depression and schizophrenia spectrum disorders. Method: Ambiguous facial expressions and emotional contexts representing anger, disgust, fear, joy, sadness and surprise were validated in a pre-test with healthy independent raters. Afterwards, 20 healthy participants (8 women, 12 men; mean age 24.35 ± 2.85 years), 20 participants with schizophrenia spectrum disorders (9 women, 11 men; mean age 40.25 ± 11.68 years) and 19 participants with depression (11 women, 8 men; mean age 43.74 ± 12.65 years) rated the emotional content of nine different faces in seven different emotion-suggesting contexts. The proportions of context-congruent answers and differences between emotion ratings in each context were analysed using non-parametric Kruskal-Wallis and explorative, paired Wilcoxon tests. Correlational analyses explored the influence of clinical symptoms assessed by clinician-administered scales. Results: The overall proportion of context-congruent answers did not differ between participants with depression and schizophrenia spectrum disorders compared to healthy participants. Participants with schizophrenia spectrum disorders were more susceptible to anger-suggesting contexts and participants with depression were more susceptible to fear-suggesting contexts. Differences in emotion recognition were associated with the severity of depressive, but not psychotic, symptoms. Conclusion: Despite increased susceptibility to anger-suggesting cues in schizophrenia and to fear-suggesting cues in depression, visual contextual influence remains largely consistent with healthy participants. Preserved emotional responsiveness suggests an efficacy of emotion training but emphasizes the need for additional research focusing on other factors contributing to social interaction deficits.

Requesting conflicts of interest declarations from the European Medicines Agency: 3-year follow-up status.

We have previously described the European Medicines Agency's (EMA) and the US Food and Drug Administration's guidelines, each for a specific psychiatric indication, on how to design pivotal drug trials used in new drug applications. Here, we report on our efforts over 3years to retrieve conflicts of interest declarations from EMA. We wanted to assess potential internal industry influence judged as the proportion of guideline committee members with industry conflicts of interest. We submitted Freedom of Information requests in February 2020 to access EMA's lists of committee members (and their declared conflicts of interest) involved in drafting the 13 'Clinical efficacy and safety' guidelines available on EMA's website pertaining to psychiatric indications. In our request, we did not specify the exact EMA committees. Here, we describe the received documents and report the proportion of members with industry interests (i.e.defined as any financial industry relationship). It is a follow-up paper to our first report (http://doi.org/10.1017/S2045796021000147). After 2years and 9months (November 2022), the EMA sent us member lists and corresponding conflicts of interest declarations from the Committee for Medicinal Products for Human use (CHMP) from 2012, 2013 and 2017. These member lists pertained to 3 of the 13 requested guidelines (schizophrenia, depression and autism spectrum disorder). The 10 remaining guidelines were published before 2011 and EMA stated that they needed to require permission from their expert members (with unknown retrieval rate) and foresaw excessive workload and long wait. Therefore, we withdrew our request. The CHMPs from 2012, 2013 and 2017 had from 34 to 36 members; 39%-44% declared any interests and we judged 14%-18% as having industry interests. For the schizophrenia guideline, we identified two members with industry interests to companies who submitted feedback on the guideline. We did not receive declarations from the Central Nervous System (CNS) Working Party, the CHMP appointed expert group responsible for drafting and incorporating feedback into the guidelines. After almost 3years, we received information, which only partly addressed our request. We recommend EMA to improve transparency by publishing the author names and their corresponding conflicts of interest declarations directly in the 'Clinical efficacy and safety' guidelines and to not remove conflicts of interest declarations after 1year from their website to reduce the risk of stealth corporate influence during the development of these influential guidelines.

The brain-gut axis: communication mechanisms and the role of the microbiome as a neuroprotective factor in the development of neurodegenerative diseases: A literature overview.

The study of the brain-gut axis and its impact on cognitive function and in the development of neurodegenerative diseases is a very timely topic of interest to researchers. This review summarizes information on the basic mechanisms of gut-brain communication. We then discuss the roles of the gut microbiome as a neuroprotective factor in neurodegeneration. The gut microbiota is extremely important in maintaining the body's homeostasis, shaping the human immune system and the proper functioning of the brain. The intestinal microflora affects the processes of neuroplasticity, synaptogenesis, and neuronal regeneration. This review aims to explain changes in the composition of the bacterial population of the intestinal microflora among patients with Alzheimer's disease, Parkinson's disease, and multiple sclerosis. Abnormalities in gut microflora composition are also noted in stress, depression, or autism spectrum development. New observations on psychobiotic supplementation in alleviating the symptoms of neurodegenerative diseases are also presented.

Psychological and psychiatric issues in patients diagnosed with cancer: A review study

Getting diagnosed with cancer can be a tremendous stressor; it can even be recognized as an emotional trauma that can lead to several mental health problems and dysfunction in many aspects of one’s life. Recent studies demonstrated that mental health issues can affect the quality of life, compliance with cancer treatment, medication efficacy, mortality rate costs of health services, and economic loss of cancer patients. In this review study, we gathered the literature by searching the databases, including Web of Science, Scopus, and PubMed. Google Scholar search engine was also used to make an extensive search strategy. We chose articles based on reporting the prevalence rate of mental health problems and the psychological and psychiatric problems that can influence the treatment of patients with cancer. The literature review showed that one-third of all cancer patients suffer from psychiatric disorders and psychological dysfunctions, and the most common mental disorders that can be comorbid with cancer are depression spectrum and anxiety disorders.

The Fruit in Alleviating Neurological Diseases via the Gut-Brain Axis

Fruits, as an important component of a healthy diet, not only contain essential nutrients for daily life, but also contain various bioactive substances, which have beneficial effects on human health. Currently, research on fruit function has focused on fruit and gut microbiota. The gut microbiota affects many important functions of the body through metabolism. At present, the relationship between gut microbiota and brain diseases, metabolic diseases, etc. has become a research focus. In the study of fruits and gut microbiota, researchers have found that it is mainly through regulating the composition of short chain fatty acids (SCFA). It is currently known that disorder of SCFA in the gut is one of the important mechanisms for some diseases. Mental disorders such as depression and autism spectrum disorder (ASD), are all associated with SCFA. Meanwhile, with the study of fruit and gut microbiota, it may be possible to prevent or even alleviate some neurological diseases by modifying the intake of fruits. In recent years, gut microbiota, ASD, and fruit intake have become important issue, and there are many related literature but a lack of systematic review. This paper analyzed the impact of different types of fruits on gut microbiota, as well as the disruption of SCFA caused by changes in gut microbiota in patients with neurological diseases. It also demonstrates that some bioactive substances can regulate SCFA, providing ideas for the treatment and alleviation of some diseases.

‘Far Away from Home’: adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study

BackgroundThe increasing prevalence and acuity of mental disorders among children and adolescents have placed pressure on services, including inpatient care, and resulted in young people being admitted at-distance or to...

Trends in Prevalence of Cannabis Use Disorder Among U.S. Veterans With and Without Psychiatric Disorders Between 2005 and 2019.

Cannabis use disorder diagnoses are increasing among U.S. adults and are more prevalent among people with comorbid psychiatric disorders. Recent changes in cannabis laws, increasing cannabis availability, and higher-potency cannabis may have placed people with cannabis use and psychiatric disorders at disproportionately increasing risk for cannabis use disorder. The authors used Veterans Health Administration (VHA) data to examine whether trends in cannabis use disorder prevalence among VHA patients differ by whether they have psychiatric disorders. VHA electronic health records from 2005 to 2019 (N range, 4,332,165-5,657,277) were used to identify overall and age-group-specific (<35, 35-64, and ≥65 years) trends in prevalence of cannabis use disorder diagnoses among patients with depressive, anxiety, posttraumatic stress, bipolar, or psychotic spectrum disorders and to compare these to corresponding trends among patients without any of these disorders. Given transitions in ICD coding, differences in trends were tested within two periods: 2005-2014 (ICD-9-CM) and 2016-2019 (ICD-10-CM). Greater increases in prevalence of cannabis use disorder diagnoses were observed among patients with psychiatric disorders compared to those without (difference in prevalence change, 2005-2014: 1.91%, 95% CI=1.87-1.96; 2016-2019: 0.34%, 95% CI=0.29-0.38). Disproportionate increases in cannabis use disorder prevalence among patients with psychiatric disorders were greatest among those under age 35 between 2005 and 2014, and among those age 65 or older between 2016 and 2019. Among patients with psychiatric disorders, the greatest increases in cannabis use disorder prevalences were observed among those with bipolar and psychotic spectrum disorders. The findings highlight disproportionately increasing disparities in risk of cannabis use disorder among VHA patients with common psychiatric disorders. Greater public health and clinical efforts are needed to monitor, prevent, and treat cannabis use disorder in this population.

Neurophysiological explorations across the spectrum of psychosis, autism, and depression, during wakefulness and sleep: protocol of a prospective case–control transdiagnostic multimodal study (DEMETER)

BackgroundQuantitative electroencephalography (EEG) analysis offers the opportunity to study high-level cognitive processes across psychiatric disorders. In particular, EEG microstates translate the temporal dynamics of neuronal networks throughout the brain. Their alteration may reflect transdiagnostic anomalies in neurophysiological functions that are impaired in mood, psychosis, and autism spectrum disorders, such as sensorimotor integration, speech, sleep, and sense of self. The main questions this study aims to answer are as follows: 1) Are EEG microstate anomalies associated with clinical and functional prognosis, both in resting conditions and during sleep, across psychiatric disorders? 2) Are EEG microstate anomalies associated with differences in sensorimotor integration, speech, sense of self, and sleep? 3) Can the dynamic of EEG microstates be modulated by a non-drug intervention such as light hypnosis?MethodsThis prospective cohort will include a population of adolescents and young adults, aged 15 to 30 years old, with ultra-high-risk of psychosis (UHR), first-episode psychosis (FEP), schizophrenia (SCZ), autism spectrum disorder (ASD), and major depressive disorder (MDD), as well as healthy controls (CTRL) (N = 21 × 6), who will be assessed at baseline and after one year of follow-up. Participants will undergo deep phenotyping based on psychopathology, neuropsychological assessments, 64-channel EEG recordings, and biological sampling at the two timepoints. At baseline, the EEG recording will also be coupled to a sensorimotor task and a recording of the characteristics of their speech (prosody and turn-taking), a one-night polysomnography, a self-reference effect task in virtual reality (only in UHR, FEP, and CTRL). An interventional ancillary study will involve only healthy controls, in order to assess whether light hypnosis can modify the EEG microstate architecture in a direction opposite to what is seen in disease.DiscussionThis transdiagnostic longitudinal case–control study will provide a multimodal neurophysiological assessment of clinical dimensions (sensorimotor integration, speech, sleep, and sense of self) that are disrupted across mood, psychosis, and autism spectrum disorders. It will further test the relevance of EEG microstates as dimensional functional biomarkers.Trial registrationClinicalTrials.gov Identifier NCT06045897.

FRI524 Improving The Quality Of Life In Patients With Not Adequately Treated Hypothyroidism: The Impact Of Comprehensive Thyroid Care For Hypothyroid Patients

Abstract Disclosure: V. Högqvist Tabor: Consulting Fee; Self; Butterfly Technologies Inc. M. Tarasova: Employee; Self; Butterfly Technologies Inc. Owner/Co-Owner; Self; Butterfly Technologies Inc. G. Cohen-Skalli: Owner/Co-Owner; Self; Butterfly Technologies Inc. F. Dubois: Employee; Self; Butterfly Technologies Inc. B. Curran: Employee; Self; Butterfly Technologies Inc. Underactive thyroid is affecting approximately 25 million people in the USA. Even though the treatment of the basic condition has been established in form of hormone replacement, there is a considerably large group of patients that continues to experience a plethora of hypothyroidism symptoms and suffer from poor quality of life. The lack of individualized approach, combined with the lack of preventive health management strategies, increases the risk of many health complications: obesity, type 2 diabetes, depressive spectrum disorders, infertility, muscle and bone problems, heart conditions, and dementias. Presently, the Paloma Health Thyroid Solution consists of a virtual clinic providing holistic thyroid care and an app for hypothyroid patients, it enables patients to receive care by medical experts in the field of endocrinology, autoimmune diseases and hypothyroidism as well as a nutritionist. In addition, it provides at-home thyroid hormone test kits, symptom recording, offers a library of informational articles, and connects the community of hypothyroid patients. The 12-week program offered to new patients facilitates learning about the most important aspects of managing the condition, including implementation of a phased elimination diet (known as the Autoimmune Protocol, AIP). Patients reported to feel more empowered, taken care of and understood after using Paloma Health Thyroid Solution. At the same time physicians have a real-time patient dashboard, and can promptly recognise signs of health worsening in patients and help correct the health management. In order to evaluate the usefulness of the approach, we have selected 45 patients that were diagnosed with hypothyroidism for at least six months, have been prescribed hormone replacement treatment, and have reported (i) low energy, (ii) low focus, (iii) sensitivity to cold, and (iv) headaches. Symptoms were recorded on a 5-point Likert scale starting from the most intense symptom experience to the absence of the symptom. We analyzed recorded symptoms, starting at the first day when patients started using Paloma Health Thyroid Solution and for the next 12 weeks. We averaged symptom experiences per patient, per week in order to have a better representation of symptom intensity for each given week. We found that patients using Paloma Health comprehensive services significantly improved symptoms related to an under-active thyroid: energy, focus, intolerance to cold and headache. The improvement was first detectable after 2 weeks of start of Paloma Health Thyroid Service, and continued the positive improvement trend for the full duration of the time period. Here we show for the first time that using the combination of accessible and individualised approach, coupled with digital technology enabling easy access to both skilled healthcare specialists as well as the vetted information and empathic support services (care manager and community) can help patients experiencing unresolved thyroid symptoms, despite previously prescribed therapy. Using virtual clinics offering preventive health management catered specifically to each individual holds a promise of helping the group of patients that currently do not fully benefit from one approach-fits-all treatment that has been hampering hypothyroid health management for the past 40 years. This approach has the potential to both reduce the burden on patients and healthcare practitioners and save costs for payers. Presentation: Friday, June 16, 2023

Psychiatric diagnoses and criminal convictions in youth: A population-based study of comorbidities of diagnoses

BackgroundPsychiatric diagnoses are important risk factors for criminal convictions, but few longitudinal studies have examined comorbidity patterns in relation to youth criminal convictions. AimTo explore associations between specific psychiatric diagnoses (substance use disorder (SUD), ADHD, depression, PTSD, intellectual disabilities (ID), and autism spectrum disorders (ASD)) and comorbidities of internalizing, externalizing, or neurodevelopmental diagnoses (NDD) in relation to risk of non-violent or violent criminal convictions in youth, including potential sex differences. MethodsData on 1,411,538 individuals born in Sweden (1985–1998) were obtained from national population-based registers. Exposure was psychiatric diagnoses and outcome was criminal convictions between ages 15 and 20. Results17% of individuals had a psychiatric diagnosis, of whom 20% were convicted of a crime. All diagnoses, except ID and ASD, increased the risk of non-violent and violent crimes. Comorbidities of externalizing and internalizing diagnoses heightened the risk compared to single diagnoses. NDD increased the risk among SUD, depression, and PTSD, while NDD comorbid with another NDD decreased the risk for criminal convictions. ConclusionOf the three comorbidity categories, externalizing disorders heightened risk the most, followed by internalizing disorders. This study highlights specific risk patterns for criminal convictions related to comorbidities, and to crime type and sex.

A new diagnostic tool for brain disorders: extracellular vesicles derived from neuron, astrocyte, and oligodendrocyte.

Brain disorders are the leading cause of disability worldwide, affecting people's quality of life and causing economic burdens. The current clinical diagnosis of brain disorders relies solely on individual phenotypes and lacks accurate molecular biomarkers. An emerging field of research centers around extracellular vesicles (EVs), nanoscale membrane vesicles which can easily cross the blood-brain barrier. EVs in the blood are derived from various tissues, including the brain. Therefore, purifying central nervous system (CNS)-derived EVs from the blood and analyzing their contents may be a relatively non-invasive way to analyze brain molecular alterations and identify biomarkers in brain disorders. Recently, methods for capturing neuron-derived EVs (NDEs), astrocyte-derived EVs (ADEs), and oligodendrocyte-derived EVs (ODEs) in peripheral blood were reported. In this article, we provide an overview of the research history of EVs in the blood, specifically focusing on biomarker findings in six major brain disorders (Alzheimer's disease, Parkinson's disease, schizophrenia, bipolar disorder, depression, and autism spectrum disorder). Additionally, we discuss the methodology employed for testing CNS-derived EVs. Among brain disorders, Alzheimer's disease has received the most extensive attention in EV research to date. Most studies focus on specific molecules, candidate proteins, or miRNAs. Notably, the most studied molecules implicated in the pathology of these diseases, such as Aβ, tau, and α-synuclein, exhibit good reproducibility. These findings suggest that CNS-derived EVs can serve as valuable tools for observing brain molecular changes minimally invasively. However, further analysis is necessary to understand the cargo composition of these EVs and improve isolation methods. Therefore, research efforts should prioritize the analysis of CNS-derived EVs' origin and genome-wide biomarker discovery studies.

Stratifying early-onset emotional disorders: using genetics to assess persistence in young people of European and South Asian ancestry.

Depression and anxiety are the most common mental health problems in young people. Currently, clinicians are advised to wait before initiating treatment for young people with these disorders as many spontaneously remit. However, others develop recurrent disorder but this subgroup cannot be identified at the outset. We examined whether psychiatric polygenic scores (PGS) could help inform stratification efforts to predict those at higher risk of recurrence. Probable emotional disorder was examined in two UK population cohorts using the emotional symptoms subscale of the Strengths and Difficulties Questionnaire (SDQ). Those with emotional disorder at two or more time points between ages 5 and 25 years were classed as 'recurrent emotional disorder' (n = 1,643) and those with emotional disorder at one time point as having 'single episode emotional disorder' (n = 1,435, controls n = 8,715). We first examined the relationship between psychiatric PGS and emotional disorders in childhood and adolescence. Second, we tested whether psychiatric PGS added to predictor variables of known association with emotional disorder (neurodevelopmental comorbidity, special educational needs, family history of depression and socioeconomic status) when discriminating between single-episode and recurrent emotional disorder. Analyses were conducted separately in individuals of European and South Asian ancestry. Probable emotional disorder was associated with higher PGS for major depressive disorder (MDD), anxiety, broad depression, ADHD and autism spectrum disorder (ASD) in those of European ancestry. Higher MDD and broad depression PGS were associated with emotional disorder in people of South Asian ancestry. Recurrent, compared to single-episode, emotional disorder was associated with ASD and parental psychiatric history. PGS were not associated with episode recurrence, and PGS did not improve discrimination of recurrence when combined with clinical predictors. Our findings do not support the use of PGS as a tool to assess the likelihood of recurrence in young people experiencing their first episode of emotional disorder.

Nasogastric tube feeding under physical restraint: comprehensive audit and case series across in-patient mental health units in England.

To identify the clinical characteristics of patients receiving nasogastric tube (NGT) feeding under physical restraint. Clinicians participated via professional networks and subsequent telephone contact. In addition to completing a survey, participants were invited to submit up to ten case studies. The survey response rate from in-patient units was 100% and 143 case studies were submitted. An estimated 622 patients received NGT feeding under restraint in England in 2020-2021. The most common diagnosis was anorexia nervosa (68.5-75.7%), with depression, anxiety and autism spectrum disorder the most frequent comorbidities. Patients receiving the intervention ranged from 11 to 60 years in age (mean 19.02 years). There was wide variation in duration of use, from once to daily for 312 weeks (mode 1 week; mean 29.1 weeks, s.d. = 50.8 weeks). NGT feeding under restraint is not uncommon in England, with variation in implementation. Further research is needed to understand how the high comorbidity and complexity contribute to initiation and termination of the intervention.

A study to assess utility of diabetes anxiety depression scale in diabetic patients and to correlate its scores with glycaemic control

Background: According to the International Diabetes Federation “diabetes is one of the largest global health emergencies of the 21st century”. Depression and anxiety have been identified as frequent co-morbid condition in Type 2 diabetes, which is itself associated with worse outcomes including increased mortality. People with diabetes are 2 to 3 times more likely to have depression than people without diabetes. Only 25% to 50% of people with diabetes who have depression get diagnosed and treated. The diabetes anxiety depression scale (DADS) is a potentially useful instrument in screening for anxious depression in people with type 2 diabetes in clinical practice. Methods: The study was a prospective observational study done on 100 Diabetic patients in a tertiary care hospital in Bangalore during the period of 2 months from November 2022 to December 2022. Results: Among the subjects studied,57% were Male and 43% were female. The maximum number of subjects i.e., 31% were in the age group of 51-60 years. Then mean duration of Type 2 DM in the study subjects was 12.34 years. 53% were found to have poor glycaemic control which is a HbA1C value of more than equal to 8%. 31% of them scored 18-39. Score of 18-39 was suggestive of major anxious depression. Conclusions: Anxious depression was prevalent across all categories of glycemic variability. There was no statistically significant difference among glycemic variability across the anxious depression spectrum. DADS score had a positive correlation with increasing age. Male diabetic patients had more anxious depression than female patients. Female diabetic patients had poorer diabetic control over prolonged periods of time. The present study findings have potential clinical implications but also have certain limitations in terms of sample size.

Bilateral subdiaphragmatic vagotomy modulates the peripheral met‑enkephalin and striatal monoamine responses to peripheral inflammation in rat.

In the central nervous system, long‑term effects of a vagotomy include disturbance of monoaminergic activity of the limbic system. Since low vagal activity is observed in major depression and autism spectrum disorder, the study aimed to determine whether animals fully recovered after subdiaphragmatic vagotomy demonstrates neurochemical indicators of altered well‑being and social component of sickness behavior. Bilateral vagotomy or sham surgery was performed in adult rats. After one month of recovery, rats were challenged with lipopolysaccharide or vehicle to determine the role of central signaling upon sickness. Striatal monoamines and met‑enkephalin concentrations were evaluated using HPLC and RIA methods. We also defined a concentration of immune‑derived plasma met‑enkephalin to establish a long‑term effect of vagotomy on peripheral analgesic mechanisms. The data indicate that 30 days after vagotomy procedure, striatal dopaminergic, serotoninergic, and enkephalinergic neurochemistry was altered, both under physiological and inflammatory conditions. Vagotomy prevented inflammation‑induced increases of plasma met‑enkephalin - an opioid analgesic. Our data suggest that in a long perspective, vagotomized rats may be more sensitive to pain and social stimuli during peripheral inflammation.

Which Kind of Body in "Mental" Pathologies? Phenomenological Insights on the Nature of the Disrupted Self.

Guided by a phenomenological perspective, this paper aims to account for the existence of a corporeal consciousness-something that clinicians should take into account, not merely in the case of physical pathologies but especially in the case of mental disorders. Firstly, I will highlight three cases: schizophrenia, depression, and autism spectrum disorder. Then, I will show how these cases correspond to three different kinds of bodily existence: disembodiment (in the case of schizophrenia), chrematization (in melancholic depression), and dyssynchrony (in the autism spectrum disorder). Finally, I will argue for the importance of an "expressive common environment" between the patient and the clinician, who are two distinct, embodied conscious subjects resonating with one another. In this view, the primary goal of the therapeutic process seems to develop a shared understanding of the patient's life-world, which finds its main expression through the disrupted body.

Cognitive Fusion, Ruminative Response Style and Depressive Spectrum Symptoms in a Sample of University Students.

Psychological inflexibility is related to depressive symptoms through the 'ruminative response style' (RR) and 'cognitive fusion' (CF). We aimed at exploring whether university students were more exposed to CF, RR and depressive symptoms because of their intellectual performance than non-university students of the same age. We compared university students (US) (n = 105) vs. non-university students (NUS) (n = 76) through online administration of the 'Cognitive Fusion Questionnaire' (CFQ-7), the 'Depression-Zung Self-Assessment Scale' (ZSDS) and the 'Perseverative Thinking Questionnaire' (PTQ) (study protocol #0077818/2022, approved by the Ethical Committee of the University of Pisa, Italy). University students scored significantly higher than non-university students in the CFQ-7 Total Score (27.5 ± 9.4 vs. 24.4 ± 9.5; p = 0.040), ZSDS Total Score (41.1 ± 7.7 vs. 39.0 ± 7.3; p = 0.031), PTQ Total Score (26.1 ± 13.1 vs. 21.8 ± 13.9; p = 0.029), PTQ 'Repetitiveness' (5.3 ± 2.8 vs. 4.5 ± 2.9; p = 0.034), 'Intrusiveness' (5.8 ± 3.0 vs. 4.8 ± 3.1; p = 0.046) and 'Repetitive Negative Thinking capturing mental resources' (5.0 ± 3.1 vs. 4.0 ± 3.0; p = 0.013) (MANOVA analysis). In a binary logistic regression analysis of US (with ZSDS scores < 44 vs. ≥44 as the dependent variable, and PTQ Total Score and dimensions, CFQ-7 Total Score, age and gender as the covariates), PTQ Total Score predicted the more severe depressive symptomatology (OR = 1.44, 95% CI: 1.017-2.039; p = 0.040). We believe that RR and CF should be specifically targeted through psychoeducational/psychotherapeutic interventions in university students.